• Title/Summary/Keyword: medical management

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Changes in Providers' Behavior after the Reviewer Unification of Auto Insurance Medical Benefit Claims (자동차보험 진료비심사 일원화 이후 의료기관 진료행태 변화)

  • Kim, Jae Sun;Suh, Won Sik
    • Health Policy and Management
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    • v.27 no.1
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    • pp.30-38
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    • 2017
  • Background: This study aims to analyze the behavioral changes of healthcare providers and influencing factors after the reviewer unification of auto insurance medical benefit claims by an independent review agency. Methods: The comparison data were collected from the second half of 2013 and the same period of 2014. The key indicators are the number of admission days, the number of outpatient visits, inpatient ratio, inpatient medical expenses, and outpatient medical expenses. Results: Four indicators (number of admission days, number of outpatient visits, inpatient ratio, and outpatient medical expenses) showed statistically significant drops, while one indicator (inpatient medical expenses) showed no significant change. Conclusion: The reviewer unification of auto insurance medical benefit claims by an independent review agency showed significant reduction in cost and patient days.

Management and Regulatory Improvement of In Vitro Diagnostic Medical Devices Using Software: Proposals for Enhancing Domestic Regulations through Comparative Analysis of International Regulations (소프트웨어 활용 체외진단 의료기기의 관리 및 규제 개선: 국내외 규제 비교를 통한 국내 규제 개선 방안)

  • Soo Yeon Lim;Byeong-Ju Kwon
    • Journal of Biomedical Engineering Research
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    • v.45 no.4
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    • pp.148-161
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    • 2024
  • This study compares and analyzes domestic and international regulations on the application of software in In Vitro Diagnostic (IVD) medical devices, proposing improvements for South Korea. The research examines regulatory statuses in Europe, the United States, and Australia, identifying differences in regulatory approaches and definitions. Despite varying methods, all countries recognize the importance of software, though the regulatory scope differs. Considering the current domestic regulations, systematic improvements are essential for sustainable growth. This study suggests regulatory enhancements and draft guidelines, emphasizing the need for ongoing monitoring and stakeholder input to develop practical solutions.

Review of China Medical Industry (중국 의료시장의 이해와 진출 전략)

  • Moon, Yong
    • Korea Journal of Hospital Management
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    • v.12 no.2
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    • pp.112-132
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    • 2007
  • The purpose of this study was to basically review of the China Medical Industry. China affiliate World Trade Organization(WTO) in 2001. In accordance with the provisions of WTO, China have to open the medical industry from 2003. To do this, the contents of this article is China medical industry, investment circumstance of capital, medical market-open plan of outbound-base, and national medical market policy in now and future.

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Evaluation of the Quality of Occupational Health and Safety Management Systems Based on Key Performance Indicators in Certified Organizations

  • Mohammadfam, Iraj;Kamalinia, Mojtaba;Momeni, Mansour;Golmohammadi, Rostam;Hamidi, Yadollah;Soltanian, Alireza
    • Safety and Health at Work
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    • v.8 no.2
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    • pp.156-161
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    • 2017
  • Background: Occupational Health and Safety Management Systems are becoming more widespread in organizations. Consequently, their effectiveness has become a core topic for researchers. This paper evaluates the performance of the Occupational Health and Safety Assessment Series 18001 specification in certified companies in Iran. Methods: The evaluation is based on a comparison of specific criteria and indictors related to occupational health and safety management practices in three certified and three noncertified companies. Results: Findings indicate that the performance of certified companies with respect to occupational health and safety management practices is significantly better than that of noncertified companies. Conclusion: Occupational Health and Safety Assessment Series 18001-certified companies have a better level of occupational health and safety; this supports the argument that Occupational Health and Safety Management Systems play an important strategic role in health and safety in the workplace.

Estimate over the Number of Chronic Disease Patients and Medical Care Expenditure at the Time of Transition of Baby Boomer into 65 Years Old Aging Population (베이비붐세대가 65세 노인인구로 전환 시의 만성질환 환자수와 진료비 예측)

  • Lee, Sun-Young;Kim, Young-Hoon;Kim, Han-Sung
    • Health Policy and Management
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    • v.23 no.4
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    • pp.376-386
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    • 2013
  • Purpose: The purpose of study is to estimate the number of chronic disease patients and medical care expenditure at the time baby-boomers belong to 65 years old aging population, and compare with current 65 year-old aging population. Methods: Analysis method used an estimating formula devised by the researcher and estimated the number of chronic disease patients and medical care expenditure of each generation. Results: When comparing the estimated number of chronic diseases patients of each generation, 40.6% of the first generation, 76.4% of the second generation, 95.2% of third generation are expected to get chronic disease. When comparing each generation's total medical care expenditure, based on the estimated number of chronic diseases patients of each generation, the second generation( 1,206,251,224 thousand won) showed higher than other generation. This study compared the number of chronic disease patients and medical care expenditure between the second generation of the elderly and current elder generation. As a result, the second generation patients was higher than the fourth generation in high blood pressure, diabetes, psychological and behavioral disorder, and neurological diseases whereas the fourth generation is only high the number of patients in heart disease. As for total medical care expenditure, the second generation paid more in high blood pressure, psychological and behavioral disorder while the fourth generation in neurological disease and heart disease. Conclusion: It is desired that considering the number of chronic disease patients and medical care expenditure of baby boomers accounting for 14.6% of total population, in-depth follow-up study is carried out that inquires into what are issues with a current chronic disease management project, what business is needed in order to manage these issues, and how to fund to cover increasing medical care expenditure.

Patterns of Unintentional Domestic Injuries in Korea (우리나라 주택 내에서 발생하는 비의도적 손상의 양상)

  • Lee, Eun-Jung;Lee, Jin-Seok;Kim, Yoon;Park, Kun-Hee;Eun, Sang-Jun;Suh, Soo-Kyung;Kim, Yong-Ik
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.1
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    • pp.84-92
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    • 2010
  • Objectives: To investigate the patterns of unintentional home injuries in Korea. Methods: The study population was 12,382,088 people who utilized National Health Insurance services due to injuries (main diagnosis codes S00 to T28) during 2006. Stratified samples(n=459,501) were randomly selected by sex, age group and severity of injury. A questionnaire was developed based on the International Classification of External Causes of Injury and 18,000 cases surveyed by telephone were analyzed after being projected into population proportionately according to the response rates of their strata. Domestic injury cases were finally included. Results: Domestic injuries (n=3,804) comprised 21.1% of total daily life injuries during 2006. Women were vulnerable to home injuries, with the elderly and those of lower income (medical-aid users) tending to suffer more severe injuries. Injury occurred most often due to a slipping fall (33.9%), overexertion (15.3%), falling (9.5%) and stumbling (9.4%), with severe injury most often resulting from slipping falls, falls and stumbles. Increasing age correlated with domestic injury-related disability. Conclusions: The present findings provide basic information for development of home injury prevention strategies, with focus on the elderly.

The Selection of the Medical Institutions by Motivation of Medical Service Utilization (의료이용 동기에 따른 의료기관 선택요인)

  • Kim, Jeong-Yeon
    • Journal of Digital Convergence
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    • v.13 no.11
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    • pp.217-230
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    • 2015
  • This study investigated the differences in how medical institutions are chosen according to the motivation of medical service utilization(minor disease, major disease, chronic disease management, cosmetic). Importance order of selection for the minor disease were medical skill, kindness, rapidness, proximity, importance order of selection for major disease and cosmetic were medical skill, facilities, reputation, medical fee, importance order of selection for chronic disease management were medical skill, facilities, kindness, medical fee. From this medical study skill was a more important factor in medical institutions irrespective of motivation, subjects with the major disease tend to consider the selection of the medical institutions more important, except proximity. Medical users select medical institutions according to the motivation of visiting, and there were differences in same motivation according to socioeconomic status and information searching behavior.

Effectiveness of Medical Aid Case Management in Excessive Healthcare User by Interventions based on the Number of Accesss (의료급여 과다이용자의 중재방법별 접근횟수에 따른 사례관리 효과)

  • Song, Myeong-Kyeong;Cho, Jeong-Hyun;Kim, Soon-Ok
    • Journal of Digital Convergence
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    • v.15 no.7
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    • pp.259-269
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    • 2017
  • This study analyzed medical aid case management effects based on the number of access by visits, phone calls, letters, internal investigation, resource links, and requests, in medical aid case management business that is carried out to improve the quality of life of medical care beneficiaries and reduce financial cost. Secondary analysis study using data of 564 high-risk group in the medical aid case management and their healthcare utilization data. Letters had positive correlations with the scores of all case management domains. The higher visits was, the lower the score of self-health care ability was, and the higher the number of phone calls was, the higher the score for reasonable medical use was. While there was no significant difference in medical cost according to aid management by interventions, the higher visits and resource links were, the lower the subjects' total number of payment days was. There is a difference in the various areas of the quality of health -related life and medical use depending on case management by intervention method and its number. It is necessary to carry out the efficient number of access to case management by intervention method.

Analysis of Abdominal Trauma Patients Using National Emergency Department Information System

  • Song, In-Gyu;Lee, Jin Suk;Jung, Sung Won;Park, Jong-Min;Yoon, Han Deok;Rhee, Jung Tak;Kim, Sun Worl;Lim, Borami;Kim, So Ra;Jung, Il-Young
    • Journal of Trauma and Injury
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    • v.29 no.4
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    • pp.116-123
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    • 2016
  • Purpose: To develop an inclusive and sustainable trauma system as the assessment of burden of injuries is very much important. The purpose of this study was to evaluate the estimates and characteristics of abdominal traumatic injuries. Methods: The data were extracted from the National Emergency Department Information System. Based on Korean Standard Classification for Disease 6th version, which is the Korean version of International Classification of Disease 10th revision, abdominal injuries were identified and abdominal surgeries were evaluated with electronic data interchange codes. Demographic factors, numbers of surgeries and clinical outcomes were also investigated. Results: From 2011 to 2014, about 24,696 patients with abdominal trauma were admitted to the hospitals annually in South Korea. The number of patients who were admitted to regional and local emergency medical centers was 8,622 (34.91%) and 15,564(63.02%), respectively. Based on National Emergency Department Information System, liver was identified as the most commonly injured abdominal solid organ (39.50%, 9,754/24,696, followed by spleen (17.57%, 4,338/24,696) and kidney (12.94%, 3,195/24,696). Conclusion: This study shows that the demand for abdominal trauma care is considerable in South Korea and most of the patients with abdominal trauma were admitted to regional or local emergency centers. The results of this study can be used as good source of information for staffs to ensure proper delivery of abdominal trauma care in trauma centers nationally.